Intellectual disability is an umbrella term for a wide variety of conditions and disorders that result in difficulties with age-appropriate mental functioning. Intellectual disability is sometimes called intellectual disability disorder or cognitive impairment, although there is some argument about the accuracy of these labels since intellectual disability is not a medical condition that can be treated or cured and it may or may not affect aspects of cognitive functioning beyond intellect. In the past it was known as mental retardation, but this term is generally regarded as derogatory and antiquated.
With intellectual disabilities the symptoms must be present before a child reaches the age of 18. This is because an intellectual disability refers specifically to the difficulty in learning and in developing at an age-appropriate level of mental functioning. After age 18, some conditions can cause a decline in mental function and intellect, but because the person was able to initially learn or develop normally, these conditions are generally referred to as dementia or just cognitive impairments.
During pregnancy there are a wide variety of factors that may result in intellectual disability. Maternal illnesses can cause intellectual disability in the infant. These conditions include rubella, toxoplasmosis, hepatitis B, and syphilis herpes simplex II. In most cases, proper screening, vaccinations or appropriate treatments can reduce the chances of an infant being affected by these illnesses. Sometimes the issue is improper blood flow through the placenta and to the fetus’s brain due to partial detachment or rupture of the placenta. It is therefore important that a pregnant woman obtain proper prenatal care.
Fetal exposure to alcohol and various drugs (legal and illegal) are completely preventable causes of intellectual disability. Mothers should be aware of how substances can cross over to the fetus and cause damage to brain development. Genetic conditions such as Down syndrome, Fragile X syndrome and Prader-Willi, however, are more difficult to prevent due to the often recessive nature of these genes. In certain cases, genetic testing or counseling may identify those at risk of having an affected child. It is important that prospective parents know family histories and request such testing if appropriate.
Factors present at birth may also cause intellectual disability. Babies that are born prematurely or are of low birth weight have a much higher chance of developing an intellectual disability than those born full-term. Any restriction in blood flow to the infant during labor can also cause damage to the brain that may result in intellectual disability. Often nurses and obstetricians will monitor fetal heart rate to detect problems and employ interventions, if needed.
Trauma, at any point, is another potential cause of intellectual disability and is often preventable. Parents should be taught the dangers of shaken baby syndrome and child abuse. Damage from either can occur during one instance or may be the result of continual traumas over a prolonged period of time. Proper use of car and bike safety equipment can also prevent intellectual disability caused by trauma. Sports injuries and unforeseen accidents can also cause brain damage. In some cases, the damage continues to occur due to swelling or bleeding in the brain. Therefore, any injury to the head should be properly diagnosed and treated by a physician to limit damage.
The prognosis for a child with an intellectual disability depends on the severity of the underlying condition or trauma. Some children with intellectual disability are able to participate in a normal educational setting, and upon reaching adulthood are able to live independently with little assistance. More severe instances of intellectual disability may result in the need for total care or modified assistance for the remainder of the affected person’s life. Regardless, it is important that the child with suspected intellectual disability be evaluated as early as possible for special programs that can help the child obtain the maximum level of functioning and independence for their particular situation. Many school districts have cognitively impaired programs that teach life skills and modify curriculum to increase retention. Community organizations and mental health services may also be able to assist with needs as the child grows.